Doctors and insurers unite to reduce errors

Page Tools

Doctors' groups and medical insurers have joined forces to
develop a national program to track hospital and GP errors and near
misses, in the wake of patient safety scandals and a blowout in
indemnity costs.

While medical specialists have their own risk management systems
in place, they vary between states and among professional groups,
leaving little room for doctors, or those designing risk reduction
programs, to learn from their mistakes.

Part of the new scheme involves doctors in public and private
practice reporting their own "near misses" on a website, said
Christopher Cain, who chairs the Risk Management Working Party.

"The ultimate aim is to improve outcomes for patients by
eliminating and tracking risks," said Dr Cain, an Adelaide spinal
surgeon and also a federal councillor with the Australian Medical
Association.

Doctors will continue to report adverse outcomes to their
insurers, in order to warn them that an incident occurred.

But when the working party's data system is in place, the
information will be collected and studied in a uniform way,
allowing medical colleges to develop specific risk-reduction
policies based on the findings, he said.

Breaking the cycle of fear around medical errors - particularly
fear of litigation - was an important step in that process.

Twelve medical colleges, including those of obstetricians,
anaesthetists orthopedic practitioners and surgeons, are involved
in the risk management group. Representatives from the Medical
Insurance Industry Association of Australia are also involved.

The chairman of the Australian Council on Safety and Quality in
Health, Bruce Barraclough, said the collection of national data on
medical errors was "a very useful exercise".

The database would sit alongside the information collected by
the safety council, which includes the most serious medical errors.
These include people dying of a blood transfusion, committing
suicide while under care, surgery occurring on the wrong side of a
patient's body, and death from incorrect medication.

"These are what we call 'the never events' - the events that the
ordinary person thinks should never happen. These things do occur
rarely and we cannot learn much unless we have a national
collection of figures," he said. All states have agreed to review
the same events in the same way, he said.

The Australian Health Minister's Advisory Council, meeting this
Friday, is believed to have the issue on its agenda.

It was the initial settlement of $14.2million to Calandre
Simpson, who developed cerebral palsy after a forceps delivery,
that highlighted the vulnerability of the country's medical
insurance industry, although that amount was later reduced to just
under $11million on appeal.

The debate that followed, centred on what was described as
unsustainably high indemnity premiums for doctors in high-risk
areas such as neurosurgery and obstetrics, peaked with threats of
mass walkouts of doctors.

A rescue package from the Federal Government temporarily
resolved the issue, until the multiple inquiries in 2004 into more
than 20 patient deaths at Camden and Campbelltown hospitals again
raised the spectre of threats to patient safety.

These events placed risk reduction high on the agendas of
medical colleges and their professional members.